197610363-4-15-2026-31-AS-NGID-DTMNMZ-20260430103557

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197610363
Report Date: 04/15/2026
Date Signed: 04/15/2026 12:58:47 PM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/31/2025 and conducted by Evaluator Huma Rahimi

COMPLAINT CONTROL NUMBER: 31-AS-20250131102508

FACILITY NAME:	AAA ROYAL SENIOR LIVING FACILITY		FACILITY NUMBER:	197610363
ADMINISTRATOR:	KRISTINA ADMAYAN		FACILITY TYPE:	740
ADDRESS:	6214 BECKFORD AVE		TELEPHONE:	(818) 609-0117
CITY:	TARZANA	STATE: CA	ZIP CODE:	91335
CAPACITY:	6	CENSUS: 6	DATE:	04/15/2026
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Kristina Admayan, Administrator		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

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Staff interfered with resident’s visit.
Staff confined resident to their room.
Staff did not provide resident or their authorized representative with requested information in a timely manner.
Staff intimidated resident into signing paperwork.

INVESTIGATION FINDINGS:

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This is an amendment to the original report issued on 12/16/2025, to make correction to the final findings of the above allegations. At 10:00 AM, Licensing Program Analyst (LPA) Huma Rahimi conducted an unannounced subsequent complaint visit. LPA met with the staff and the Administrator Kristina Admayan was contacted via phone. The Administrator arrived shortly after and LPA explained the reason for the visit.

An initial complaint visit was conducted on 02/04/2025. LPA obtained resident and staff roster and other pertinent information which include, but not limited to Physician's Report, Admission Agreement, Appraisal Needs and Services Plan, etc., relevant to the investigation. LPA conducted and physical plant tour of the facility. Interviews were conducted with the Administrator, a Placement Agent, one (1) Staff, three (3) out of four (4) residents who were available at the facility. During today's visit, LPA conducted an interview with one (1) out of six (6) residents who was available.

Continue on LIC 9099C

Substantiated

Estimated Days of Completion:

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Huma Rahimi
LICENSING EVALUATOR SIGNATURE:	DATE: 04/15/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/31/2025 and conducted by Evaluator Huma Rahimi

COMPLAINT CONTROL NUMBER: 31-AS-20250131102508

FACILITY NAME:	AAA ROYAL SENIOR LIVING FACILITY		FACILITY NUMBER:	197610363
ADMINISTRATOR:	KRISTINA ADMAYAN		FACILITY TYPE:	740
ADDRESS:	6214 BECKFORD AVE		TELEPHONE:	(818) 609-0117
CITY:	TARZANA	STATE: CA	ZIP CODE:	91335
CAPACITY:	6	CENSUS: 6	DATE:	04/15/2026
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Kristina Admayan, Administrator		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

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Staff did not adequately assist resident with care needs in a timely manner.
Staff did not respect resident’s choices regarding their care needs.
Staff did not provide resident with adequate food service.
Staff spoke to resident in an inappropriate manner.

INVESTIGATION FINDINGS:

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Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Huma Rahimi
LICENSING EVALUATOR SIGNATURE:	DATE: 04/15/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 2 of 9

Control Number 31-AS-20250131102508

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: AAA ROYAL SENIOR LIVING FACILITY	FACILITY NUMBER: 197610363
	VISIT DATE: 04/15/2026

NARRATIVE

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Allegation: Staff did not adequately assist resident with care needs in a timely manner.
It was alleged that Resident #1 (R1), who uses a walker and requires assistance with ambulation and restroom use, experienced delays in staff response times when requesting assistance. It was further alleged that due to delayed responses, R1 attempted to ambulate independently and nearly fainted in the restroom on an unknown date. To investigate this allegation, LPA conducted interviews with the Administrator and Staff #1 (S1). Both denied the allegation. The Administrator stated that R1 always received assistance shortly after requesting help and that staffing levels were sufficient to meet resident needs. Staff reported that residents are monitored and assisted as needed. LPA interviewed R1 on 02/04/2025, who reported concerns regarding delays in staff responding to requests for assistance and described an incident on an unknown date in which R1 nearly fainted while using the restroom. During the visit on 02/04/2025, LPA observed staff present and providing care and supervision to all residents including R1. Based on LPA’s observation during the initial and subsequent visits, staff were available to assist residents and respond to care needs. Based on interviews conducted and LPA’s observation during the visit, there was insufficient evidence to support the claim that staff did not adequately assist R1 with care needs in a timely manner. Therefore, the allegation is Unsubstantiated. The finding is based on information gathered during the investigation regarding conditions and practices during the time R1 resided at the facility. At the time the investigation concluded, R1 was no longer residing at the facility.

Allegation: Staff did not respect resident’s choices regarding their care needs.
It was alleged that staff did not respect R1’s expressed care preferences. Specifically, it was alleged that an unknown individual provided a shower to R1 without proper identification and performed an unsolicited massage despite R1 verbally objecting. To investigate this allegation, LPA interviewed the Administrator and S1, both of whom denied the allegation. The Administrator stated that showers are provided by a designated shower aide and that the facility does not provide massages to residents. Although the Administrator was initially unable to identify the individual who provided the shower at the time of questioning, documentation obtained during the course of the investigation clarified that R1 was enrolled in hospice services with Glendale Hospice Inc beginning 01/24/2025. Records reviewed indicate that R1 received two hospice visits dated 01/28/2025 and 01/31/2025. During both visits, hospice staff provided shower assistance using a shower chair and applied lotion to R1’s skin as part of routine personal care. Documentation further reflects that R1 was discharged from hospice services on 01/31/2025 at the request of R1’s Power of Attorney (POA), who revoked hospice benefits and service Continue on LIC 9099C

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Huma Rahimi
LICENSING EVALUATOR SIGNATURE:	DATE: 04/15/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2026

LIC9099 (FAS) - (06/04)

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Control Number 31-AS-20250131102508

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: AAA ROYAL SENIOR LIVING FACILITY	FACILITY NUMBER: 197610363
	VISIT DATE: 04/15/2026

NARRATIVE

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Based on documentation reviewed and interviews conducted, the personal care services in question were provided by hospice agency staff, a third-party provider, and not by facility staff. While R1 expressed dissatisfaction with the services received, there is insufficient evidence to support that facility staff failed to respect R1’s care preferences. Therefore, the allegation is Unsubstantiated.

Allegation: Staff did not provide the resident with adequate food service.
It was alleged that staff failed to provide Resident 1 (R1) with adequate and appropriate meals, including meals consistent with R1’s dietary needs. Additionally, it was reported that R1 was repeatedly served cold sandwiches and inappropriate meals. To investigate this allegation, the Licensing Program Analyst (LPA) interviewed the Administrator, who denied the claim and stated that meals are freshly prepared. The Administrator further indicated that R1 was provided with a special low-sodium diet in accordance with their dietary requirements. Facility staff also denied the allegation, reporting that residents, including R1, are served a variety of meals, including hot meals, and are offered substitutions when necessary.
On 02/04/2025, the LPA interviewed R1, who expressed dissatisfaction with the meals and stated that cold sandwiches were served on several occasions. R1 also reported that staff encouraged them to eat the meals provided when alternatives were refused. During the initial visit on 02/04/2025, LPA observed lunch service. Residents were served a toasted sandwich, a bowl of soup, salad, juice, and water. Additionally, interviews with two (2) other residents revealed no concerns regarding food service. Based on the LPA’s observations and interviews conducted, residents were observed to be receiving adequate meals consistent with their dietary needs. Therefore, there is insufficient evidence to support the allegation that staff failed to provide R1 with adequate food service or meals consistent with dietary requirements. Therefore, the allegation is deemed Unsubstantiated at this time. This finding is based on information gathered during the investigation regarding conditions and practices while R1 resided at the facility. At the time the investigation was concluded, R1 was no longer residing at the facility.

Continue on LIC 9099C

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Huma Rahimi
LICENSING EVALUATOR SIGNATURE:	DATE: 04/15/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2026

LIC9099 (FAS) - (06/04)

Page: 4 of 9

Control Number 31-AS-20250131102508

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: AAA ROYAL SENIOR LIVING FACILITY	FACILITY NUMBER: 197610363
	VISIT DATE: 04/15/2026

NARRATIVE

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Allegation: Staff spoke to resident in an inappropriate manner.
It was alleged that staff spoke to R1 in an inappropriate and disrespectful manner, including yelling and making demeaning statements. To investigate this allegation, LPA interviewed the Administrator and S1, both of whom denied speaking inappropriately to R1 and stated residents are treated respectfully. During initial visit on 02/04/2025, LPA interviewed R1, who reported being yelled at when requesting assistance and when asking questions regarding showers and meals. R1 reported being told, “Eat it or starve.” During the initial visit, LPA did not observe any staff speaking inappropriately to R1 or any other residents in care. Moreover, LPA observed that all residents are treated with respect and dignity. Additionally, on 02/04/2025, LPA conducted interview with three (3) out of four (4) residents of which two (2) residents did not express any concern regarding the allegation and informed LPA that they are being spoken to appropriately. Therefore, based on interviews and observation this allegation is Unsubstantiated at this time. The finding is based on conditions and practices observed during the period R1 resided at the facility. At the time of the investigation conclusion, R1 was no longer residing at the facility.
Appeal rights explained.

Exit interview conducted and copy of this report signed and provided.

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Huma Rahimi
LICENSING EVALUATOR SIGNATURE:	DATE: 04/15/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2026

LIC9099 (FAS) - (06/04)

Page: 5 of 9

Control Number 31-AS-20250131102508

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: AAA ROYAL SENIOR LIVING FACILITY	FACILITY NUMBER: 197610363
	VISIT DATE: 04/15/2026

NARRATIVE

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Allegation: Staff interfered with resident’s visit.
It was alleged that staff interfered with R1’s authorized healthcare visits. Specifically, it was alleged that a Home Health Nurse sent by R1’s physician and authorized by R1’s Power of Attorney (POA) was prevented from assessing R1.
To investigate this allegation, LPA interviewed the Administrator, who denied interfering with visits and stated R1 was already receiving hospice services at the time. Additionally, LPA interviewed the Home Health Nurse, who stated that on 01/31/2025 she was prevented from completing an assessment by a hospice nurse who stated R1 was already enrolled in hospice services and that hospice was responsible for care. The nurse left the facility without completing the assessment.
LPA confirmed through interviews that hospice enrollment occurred without documented POA consent. Based on the interviews and corroborating information, the allegation is Substantiated. The finding is based on conditions and practices observed during the period R1 resided at the facility. At the time of the investigation conclusion, R1 was no longer residing at the facility.

Allegation: Staff confined resident to their room.
It was alleged that staff confined R1 to their room and restricted their access to common areas, allowing them to leave only for meals.
To investigate this allegation, LPA interviewed the Administrator, who denied restricting residents and stated residents may use common areas freely. Staff reported that residents are allowed in the living room and participate in activities.
During initial visit on 02/04/2025, LPA interviewed R1, who reported being told they had to remain in their room and could only come out for meals. During the initial visit on 02/04/2025, LPA observed residents spending the majority of the day in their rooms, no activities being offered, and residents being directed back to their rooms immediately after meals. Based on interviews and observation, the allegation is Substantiated. The finding is based on conditions and practices observed during the period R1 resided at the facility. At the time of the investigation conclusion, R1 was no longer residing at the facility.

Continue on LIC 9099C

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Huma Rahimi
LICENSING EVALUATOR SIGNATURE:	DATE: 04/15/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2026

LIC9099 (FAS) - (06/04)

Page: 6 of 9

Control Number 31-AS-20250131102508

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: AAA ROYAL SENIOR LIVING FACILITY	FACILITY NUMBER: 197610363
	VISIT DATE: 04/15/2026

NARRATIVE

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Allegation: Staff did not provide resident or their authorized representative with requested information in a timely manner.
It was alleged that staff failed to provide R1 and their authorized representative (POA) with requested information regarding care providers and medical decisions.
To investigate this allegation, LPA interviewed the Administrator, who stated attempts were made to contact the POA regarding hospice enrollment. LPA reviewed the Administrator’s outgoing call logs and did not observe any calls placed to the POA.
Furthermore, LPA interviewed the POA and placement representatives, who stated they were not informed of hospice enrollment and were not provided with information regarding individuals brought into the facility to care for R1. Based on interviews and record review, the allegation is Substantiated. The finding is based on conditions and practices observed during the period R1 resided at the facility. At the time of the investigation conclusion, R1 was no longer residing at the facility.

Allegation: Staff intimidated resident into signing paperwork.
It was alleged that staff intimidated R1 into signing paperwork by using threats or coercive behavior.
To investigate this allegation, LPA interviewed the Administrator, who denied forcing or intimidating R1 and stated paperwork was explained prior to signing. Facility staff denied witnessing coercion.
During the initial visit on 02/04/2025, LPA interviewed R1, who reported that the Administrator and an unknown male pressured them to sign paperwork, stating they had to sign “or else.” R1 reported the male became angry and that they feared physical harm. LPA observed R1 display fear and emotional distress while recounting the incident. The facility was unable to provide documentation demonstrating informed consent or POA involvement. Based on interviews and observation, the allegation is Substantiated. The finding is based on conditions and practices observed during the period R1 resided at the facility. At the time of the investigation conclusion, R1 was no longer residing at the facility.

Deficiencies issued and appeal rights explained.

Exit interview conducted and copy of this report signed and provided.

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Huma Rahimi
LICENSING EVALUATOR SIGNATURE:	DATE: 04/15/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2026

LIC9099 (FAS) - (06/04)

Page: 7 of 9

Control Number 31-AS-20250131102508

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: AAA ROYAL SENIOR LIVING FACILITY	FACILITY NUMBER: 197610363
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/15/2026

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 04/14/2026 Section Cited CCR 87468.1(a)(6)	1 2 3 4 5 6 7	(a)Residents in all residential care facilities for the elderly shall have all of the following personal rights:(6) To leave or depart the facility at any time and to not be locked into any room, building or on facility premises by day or night. This requirement is not met as evidenced by:	1 2 3 4 5 6 7	Administrator will ensure residents may freely access common areas and will retrain staff on personal rights. The POC was previously cleared on 12/19/2025 for the original report dated 12/16/25, POC is cleared during today's visit.
	8 9 10 11 12 13 14	Based on interviews and LPA's observation the Licensee did not comply by restricting R1’s movement by directing R1 to remain in his/her room except for meals. LPA observed residents spending most of the day in their rooms and being directed back after meals.	8 9 10 11 12 13 14	This poses a potential personal rights risk.
Type B 04/14/2026 Section Cited CCR 87468.2(a)(1)	1 2 3 4 5 6 7	87468.2 Additional Personal Rights... (a) …residents… shall have all of the following personal rights: (1) To have a reasonable level of personal privacy in accommodations, medical treatment, personal care and assistance, visits, communications,....This requirement is not met as evidenced by:	1 2 3 4 5 6 7	Administrator will ensure residents and POAs may receive authorized outside healthcare services. Staff will be retrained on visitor and medical access rights. The POC was previously cleared on 12/19/2025 for the original report dated 12/16/25, POC is cleared during today's visit.
	8 9 10 11 12 13 14	Based on interviews and record review the Licensee did not comply by interfered with R1’s authorized healthcare visit when a Home Health Nurse was prevented from completing an assessment. This poses a potential personal rights risk.	8 9 10 11 12 13 14

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Huma Rahimi
LICENSING EVALUATOR SIGNATURE:	DATE: 04/15/2026

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2026

LIC9099 (FAS) - (06/04)

Page: 8 of 9

Control Number 31-AS-20250131102508

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: AAA ROYAL SENIOR LIVING FACILITY	FACILITY NUMBER: 197610363
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/15/2026

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 04/22/2026 Section Cited CCR 87468.1(a)(8)	1 2 3 4 5 6 7	Personal Rights of Residents in All Facilities(a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (8) To have their representatives regularly informed by the licensee....., including ongoing evaluations, as appropriate to their needs.This requirement is not met as evidenced by:	1 2 3 4 5 6 7	Administrator will ensure that residents’ authorized representatives are informed of care and service updates in a timely manner. Staff will be trained on communication requirements and a communication log will be maintained to document all notifications. Administrator will monitor compliance.
	8 9 10 11 12 13 14	Based on interviews and record review, the Licensee did not comply with the above section by failing to provide R1 and his/her authorized representative with requested information regarding care and services in a timely manner. This poses a potential personal rights risk.	8 9 10 11 12 13 14
Type B 04/22/2026 Section Cited CCR 87468.1(a)(3)	1 2 3 4 5 6 7	Personal Rights of Residents in All Facilities (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights:(3) To be free from punishment, humiliation, intimidation, abuse,,,,,,,This requirement is not met as evidenced by:	1 2 3 4 5 6 7	Administrator will ensure residents are not subjected to intimidation or coercion when signing any paperwork. All documents will be explained prior to signature, and staff will receive training on residents’ personal rights. Proof to be submitted to LPA by POC due date.
	8 9 10 11 12 13 14	Based on interviews and record review, the Licensee did not comply with above section by subjecting R1 to intimidation and coercive behavior during the signing of paperwork. This poses a potential personal rights risk.	8 9 10 11 12 13 14

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Huma Rahimi
LICENSING EVALUATOR SIGNATURE:	DATE: 04/15/2026

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2026

LIC9099 (FAS) - (06/04)

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